Organization
ADVENTIST HEALTH PARTNERS, INC
Active
Other names
Adult Medicine Physicians of LaGrange
Organization subpart
No
Provider details
NPI number
Authorized official
RUBY MANN (DIRECTOR)
(630) 856-6884
Entity
Organization
Contact information
Practice address
5201 WILLOW SPRINGS RD, SUITE 150, LA GRANGE, IL 60525-6537
(708) 245-8120
(708) 245-8119
Mailing address
5201 WILLOW SPRINGS RD, SUITE 150, LA GRANGE, IL 60525-6537
(708) 245-8120
(708) 245-8119
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208342
MEDICARE PTAN
—
Enumeration date
04/09/2012
Last updated
06/13/2017
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